Table 1.

Domains of Potential Ambulatory Safety Concerns from Telemedicine

Dimensions of patient safety	Mechanisms through which telemedicine could worsen patient safety
Diagnostic errors	- Inadequate or lower quality history or physical exam (especially with audio-only encounters or other factors that reduce communication quality) - Reliance on patients to collect key data (vital signs, description of physical findings) - Increased cognitive load on clinician from reduction in team-based care - Changes in behaviors for diagnostic work-up
Medication safety	- Patient-provider communication challenges may impede high-quality medication reconciliation, which is an evidence-based approach to prevent adverse drug events - Lack of access to other team members to conduct more in-depth medication reconciliation (e.g., pharmacist) - Increased reliance on patients’ literacy, language skills, or technology skills to conduct medication reconciliation - Change in availability of tools that can be used to ensure shared understanding of medication regimens (e.g., after visit summaries)